Opinion

Health Care Caricature

By THE EDITORIAL BOARD

March 21, 2014

Republican leaders are making preposterous assertions that President Obama has abandoned a centerpiece of his health care reforms — the requirement that most people obtain comprehensive insurance or pay a penalty. In a cartoonish misrepresentation of how so-called hardship exemptions will be determined, the leaders, egged on by their allies in the conservative media, contend that recent steps by the administration undermine the individual mandate by giving virtually everyone who wants one a free pass to escape the penalty.

These steps are modest midcourse corrections to deal with individual problems in the rollout of a large and complex program. As long as the state and federal officials in charge proceed judiciously, the public will benefit.

The Republicans note, correctly, that some people may qualify for an exemption if their insurance was canceled and they can’t find affordable plans in the insurance marketplaces. But it’s not enough for applicants to simply say they cannot find an affordable policy; getting an exemption requires them to jump through all sorts of hoops.

Besides submitting a copy of the cancellation notice, applicants must fill out a nine-page form, under penalty of perjury, that requires information for everyone in the family about income, employment and any job-related health insurance. In addition, there is no certainty that an application will be approved. That judgment will be made by the federal and state officials who run the marketplaces. We hope and expect that they will award exemptions judiciously, rejecting applicants who make willful efforts to evade the law and approving those who made good faith efforts to find affordable policies.

Republicans also point to a catchall category that says that people may be eligible for an exemption if they “experienced another hardship in obtaining health insurance,” such as, perhaps, difficulty completing enrollment through balky websites. They must submit documentation “if possible.” But applicants who fail to document their case will only weaken their chances of getting an exemption. As always, exchange officials will make the final judgment and, we assume, reject specious claims.

Finally, Republicans point to a political maneuver by the administration that allowed insurers to renew existing policies for another two years, a move clearly designed to reduce the likelihood of consumer gripes just before the midterm elections. But renewal is not a sure thing. Insurers may not want to renew the old plans, and state insurance commissioners may not allow them to. In November, when the administration told insurers they could choose to reinstate canceled policies for a year, 21 states and the District of Columbia refused to allow it.